Twenty minutes after arrival initial therapy, arterial blood gas data are obtained with the following results:
pH: 7.48
PaO2: 210 mmHg
PaCO2: 28 mmHg
SaO2: 89%
HCO3: 21 mEq
Hgb: 14.2 gms
COHgb: 10.4%
Because of the presence of carbon monoxide on the hemoglobin, the patient continues to receive oxygen via nonrebreathing mask. He is still alert; his anxiety is gradually lessening.
Three hours later, his COHgb has decreased to 6.1% and he is breathing comfortably. The nonrebreathing mask is replaced with a 40% Venturi (air entrainment) mask. He remains in ED for observation.
Six hours after admission, his respirations become more rapid and labored. Auscultation reveals fine crackles throughout both lungs. A portable chest film shows bilateral infiltrates extending into all four lung quadrants. Arterial blood is again drawn:
pH: 7.37
PaO2: 66 mmHg
PaCO2: 38 mmHg
SaO2: 88%
HCO3: 21 mEq
COHgb: 3.9%
FiO2: 40% (Venturi mask)

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